Do you know the Truth about Fluoride?
By now, most of us would be quite familiar with the word ‘Fluoride’. We may have learnt about it during a Grade 9 science class, seen it on a box of toothpaste or more than likely, heard the dentist bang on about how amazing fluoride is for your teeth. Well, what’s so special about fluoride? We’ve been told it helps fight tooth decay. But how?
Watch the first episode of [prevent] about Fluoride Safety above, but otherwise, to find out more about fluoride and how it works, read on.
Fluoride is a mineral that naturally exists in rock, air, soil, plants, water and it also exists as a component of your tooth enamel and bones. To understand how fluoride helps prevent decay and to a certain extent reverse it, we have to first learn more about what tooth enamel is, how decay works and the role saliva play in all of this.
Why Do I Get Tooth Decay?
Tooth enamel is the outer most layer of your teeth. It’s the hardest substance in the human body i.e. stronger than bone and is primarily made up of hydroxyapatite, which is a crystalline form of calcium and phosphate. When you eat anything that contains sugar, whether it be from chocolate, fruit, potatoes or bread, decay-causing bacteria that live in our mouth feast on these sugars and start producing acid. The acid in turn attacks your enamel, causing the calcium and phosphate to leach out, leaving you vulnerable to decay. This process is termed demineralisation.
The tooth decay process
Don’t worry, it’s not all doom and gloom. Fortunately, saliva a.k.a spit, actually does more than lubricate your mouth. It also helps disrupt the acid attack on your enamel! Amongst other electrolytes, saliva also contains calcium and phosphate. In addition to neutralising the acid produced by the bacteria in your mouth, saliva also replenishes your enamel with calcium and phosphate to replace what has been stripped away. This process is called remineralisation.
Remineralisation vs Demineralisation
Throughout the day, a balance between the process of demineralisation and remineralisation exists in our mouth. So long as the rate between these two processes remain in balance, teeth remain strong and healthy. It is when the rate of demineralisation takes over, that’s when we’re in trouble. When more minerals are lost from enamel than replaced, tooth decay forms.
Remineralisation in a Tug Of War with Demineralisation
How Does Fluoride Help?
When you drink tap water (tap water is fluoridated, bottled water generally isn’t!) or brush your teeth with a fluoridated toothpaste, the fluoride gets incorporated into your saliva. It then interacts with the hydroxyapatite in your enamel to form a stronger compound that is more resistant to acid attack called FLUOROAPATITE.
Fluoride makes tooth enamel more resistant to tooth decay
Because the enamel is now harder due to the fluoroapatite, this means it’s better equipped to withstand the acid attack by the decay-causing bacteria which means decay is less likely to form. Many years of studies have shown that fluoride can prevent, stop and sometimes even reverse decay, especially in its very early stages. Fluoride also speeds up the process of remineralisation which means damaged enamel can recover a lot quicker. Newer studies have also shown fluoride reduces the risk of decay by interfering with the decay-causing bacteria’s ability to stick to our teeth. This means the acid that the bacteria produce is less likely to come into contact with the teeth.
Can My Child Have Fluoride?
YES! But be sure to control their access to and exposure to fluoride-containing toothpastes depending on their age. Kids have a habit of swallowing their toothpaste when they are very young and this can potentially lead to white and brown spots developing on their teeth – called fluorosis. This is why toothpastes come in different formulations.
So, if you have very young children (3 years and under), who are prone to swallowing their toothpaste, make sure you use a low-dose fluoride toothpaste ie. The box should say at or below 550 parts per million (ppm).
When they are better able to follow instructions and spit out toothpaste thoroughly you can introduce a higher dose of fluoride ie. 1000ppm, up to 1450ppm, available in regular adult toothpastes and some children’s toothpastes.
How Can I Stop Tooth Decay?
So how do I get fluoride onto my teeth you ask? Here’s a list of things you can do to help reduce your risk of tooth decay:
Tip 1: Drink tap water – Bottled water does not always contain fluoride
Tip 2: Brush twice a day with ONLY fluoridated toothpaste
Tip 3: After brushing, spit out the excess toothpaste BUT do not rinse! Leaving some toothpaste on your teeth is a great way to give your teeth extra ongoing fluoride protection.
Tip 4: Visit your trusted dentist regularly. If you are at risk of tooth decay (especially children due to their inconsistent brushing habits and poorer diet choices), your dentist may even recommend a professional-strength fluoride treatment to provide a superior level of tooth-decay prevention.
If you’d like to have Dr. Grant check your risk of tooth decay and apply a professional fluoride treatment if necessary, please contact us here.
I’ve Heard Fluoride Isn’t Safe. Is This True?
The short answer is that fluoride is safe. The long answer is that when it comes to whether anything is toxic, the dose or amount of the substance is the key factor. The dose makes the poison.
The recommended levels of fluoride in water supplies is around 1 part per million – that is, one molecule out of one million molecules is fluoride. This varies depending on the climate and likely water intake, but is set very low and you are not physically able to drink enough water to make this level of fluoride poisonous.
Of course, toothpastes with fluoride have much higher concentrations and they can be dangerous for children if too much toothpaste is swallowed (see above). Fluoride has been added to toothpastes for over 100 years and there is no evidence showing harmful health effects from use of fluoride-containing toothpastes.
The benefits of fluoride in the currently recommended doses are clear and if you ask me, there should be a superhero named after fluoride!
The Australian Dental Association agrees too and you can read more from them here.
Dr. Grant McGrath BDSc
Jasmine Ooi BPharm